45D0954261 CLIA NUMBER - CHILDRENS CLINIC OF EL PASO PA

Laboratory Demographics

CLIA Number: 45D0954261

Facility Name: CHILDRENS CLINIC OF EL PASO PA

Facility Address:
11544 VISTA DEL SOL BLDG A
EL PASO, TX
ZIP 79936
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Facility Phone Number: 915 592-2600

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1871990747

Taxonomy: 283Q00000X - Psychiatric Hospital
An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings.

CLIA Record

Field Name	Field Value
CLIA Number	45D0954261
LAB Type	Physician Office
Facility Name	CHILDRENS CLINIC OF EL PASO PA
Street	11544 VISTA DEL SOL BLDG A
City	EL PASO
State	TX
ZIP	79936
Phone	915 592-2600
CertificateType	4
CertificateEffectiveDate	11/20/2022
CertificateExpirationDate	11/19/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024